Provider Demographics
NPI:1114617263
Name:SPAHIDAKIS, ANTHOULA MARIA (AUD)
Entity Type:Individual
Prefix:DR
First Name:ANTHOULA
Middle Name:MARIA
Last Name:SPAHIDAKIS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:ANNA
Other - Middle Name:MARIA
Other - Last Name:SPAHIDAKIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AUD
Mailing Address - Street 1:119 E 84TH ST UNIT 1A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0939
Mailing Address - Country:US
Mailing Address - Phone:347-342-6114
Mailing Address - Fax:
Practice Address - Street 1:119 E 84TH ST UNIT 1A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0939
Practice Address - Country:US
Practice Address - Phone:347-342-6114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003125-01237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter